Abstract
Maternal diet, physical activity (PA) behaviours, and gestational weight gain (GWG) are important for optimum health of women and their babies. This secondary analysis of the GLOWING pilot cluster trial explored these among women living with obesity in high deprivation. Pregnant women completed food frequency, PA and psychosocial questionnaires. Weights were retrieved from medical records and measured during routine appointments with midwives. Descriptive and regression analyses were stratified by obesity class. A total of 163 women were recruited; 54.0% had class 1 obesity, 25.8% class 2, 20.2% class 3, and 76.1% lived in the two most deprived quintiles. Women had suboptimal dietary intake, particularly for oily fish, fruit and vegetables. PA was predominantly light intensity, from household, care and occupational activities. Most women gained weight outside of Institute of Medicine (IOM) guideline recommendations (87.8%); women in class 3 obesity were most likely to have inadequate GWG below IOM recommendations (58.3%, p < 0.01) and reduced odds of excessive GWG compared with class 1 (AOR 0.13, 95% 0.04–0.45). Deprived women with obesity have a double inequality as both increase pregnancy risks. This population requires support to meet guideline recommendations for diet, PA and GWG. Further research exploring obesity classes would inform policies and care to achieve the best pregnancy outcomes.
Highlights
In the UK, approximately one in five women who access maternity services have a body mass index (BMI) in the obese range (BMI ≥ 30 kg/m2 ) [1], with the odds of obesity being up to five-fold higher among women living in areas of highest versus least deprivation [2]
Pregnancy is an opportunity for intervention to improve maternal diet and physical activity (PA) behaviours and limit gestational weight gain (GWG) which can reduce the risk of GDM, hypertensive disorders of pregnancy, and caesarean section, and improve maternal cardiorespiratory fitness [8,9,10,11]
This study aimed to explore maternal patterns of diet and PA behaviours, and GWG
Summary
In the UK, approximately one in five women who access maternity services have a body mass index (BMI) in the obese range (BMI ≥ 30 kg/m2 ) [1], with the odds of obesity being up to five-fold higher among women living in areas of highest versus least deprivation [2]. The short- and long-term risks of maternal obesity are multiple and severe, including gestational diabetes (GDM), pre-eclampsia, maternal and offspring mortality [3,4,5], and a 264% increase in the odds of childhood obesity in offspring [6], which may be in part due to nutritional epigenetic changes in utero [7]. Pregnancy is an opportunity for intervention to improve maternal diet and physical activity (PA) behaviours and limit gestational weight gain (GWG) which can reduce the risk of GDM, hypertensive disorders of pregnancy, and caesarean section, and improve maternal cardiorespiratory fitness [8,9,10,11]. There are currently no national GWG guidelines in the UK other than recommendations that women should not try to reduce obesity-related risks by “dieting”
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